Post Graduate Diploma in Geriatric Medicine





This programme is a Diploma Programme of three years duration. It is aimed at MBBS doctors. This programme will equip the in-service doctors with knowledge and skills in the field of Geriatric Medicine and further enable them to deal with the special problems faced by the elderly. It is proposed to have 10 to 12 programme study centres in the first year.

It must be appreciated that the epidemiological and the clinical features of disease vary in this age as compared to the younger generation. Drug dosages and interactions also differ. Geriatric management requires not only medical interventions but also special economic and environmental interventions. This programme aims at not only enhancing the knowledge but also multiskilling the doctors so as that they can provide primary level care to the elderly.

Objectives

The broad Objectives of the Programme are to

1. Upgrade the knowledge and skills for providing comprehensive health care to elderly

2. Inculcate the inter-disciplinary approach for diagnosing and management of geriatric health problems

3. Improve the clinical, social and communication skills by providing hands on training in medical colleges and district hospitals.

Admission fee : Rs. 12,500/-

Duration : Minimum 1 year Maximum 3 years

Eligibility : MBBS doctors

Number of Seats : Each centre to have a maximum of 30 students

Implementation

The hands-on-training is proposed to be offered involving a three tier system i.e. demonstrations and discussions at Medical colleges called Programme Study Centre (PSC), supervisory practice at district level /secondary level hospitals called Skill Development Centres (SDC) and self activity at own Work Place (WP) with maintenance of records. The training at the programme study centres and the skill development centres would be done by trained teachers called counsellors. To ensure quality training, a three tier monitoring system would be operational i.e. the core faculty at head quarter level, Regional Health sciences Advisory Committee (RHSAC) at state level and Regional Consultants at SDC level. The hands-on-training of all students would be recorded in logbooks and verified by concerned Counsellors.

Video : To be developed

Examination & Evaluation

The evaluation system would include continuous and term-end assessment both for the theory and practical components.

The students would be expected to clear both the theory and the practical separately. In the theory, thirty percent of weightage would be given to the internal assignment and seventy percent to the term end examination. The minimum pass percentage for both theory and practical separately would be fifty per cent.

In the practical, weightage of thirty per cent for internal assessment and seventy per cent for term end examination. The individual pass percentage of term-end and continuous assessment would be fifty per cent. The students would be required to maintain log-books which will be signed before they will be allowed to appear for their term-end practical.

The programme design is mentioned in section 2.2. The block-wise details are mentioned in the following section and the detailed syllabi are mentioned in a separate section.

SYLLABI

• Course-wise List of Blocks

Course MME-004: Basic Geriatrics

Block-1 : Demography and Epidemiology of Aging

Block-2 : Biological Process of Aging

Block-3 : Making Elderly Less Vulnerable

Block-4 : Coping with Aging

Block-5 : Psychosocial Geriatrics

Block-6 : Rehabilitation Geriatrics

Course MMEL-004: Basic Geriatrics Practical

Block-1 : Practical Manual

Block-2 : Log-book

Course MME-005: Clinical Geriatrics

Block-1 : Different Face of Clinical Geriatrics

Block-2 : Gastrointenstinal and Respiratory Disorders

Block-3 : Cardiovascular and Haematological Disorders

Block-4 : CNS and Neuro-psychiatric Disorders

Block-5 : Genitourinary and Endocrinological Disorders

Block-6 : Musculoskeletal and Special Senses Disorders

Block-7 : Malignancies and Terminally Ill

Block-8 : Miscellaneous Disorders

Course MMEL-005: Clinical Geriatrics Practical

Block-1 : Practical Manual

Block-2 : Log-book

• Block-wise Details of Each Course

Course MME-004: Basic Geriatrics

Block-1: Demography and Epidemiology of Aging

Unit 1 : From pyramid to Pillar

Unit 2 : Manifestation of Demographic Transition

Block-2: Biological Process of Aging

Unit 1 : Biological Changes

Unit 2 : Nutrition

Unit 3 : Psychosocial Changes

Unit 4 : Pharmacokinetics and Pharmacodynamics

Block-3: Making Elderly Less Vulnerable

Unit 1 : Aging Gracefully

Unit 2 : Risk Factor Management and Screening

Block-4: Coping with Aging

Unit 1 : Environmental Facilitation

Unit 2 : Alternative Medicine and Therapies

Unit 3 : Health Education and Counselling

Block-5: Psychosocial Geriatrics

Unit 1 : Dependence, Independence and Competence

Unit 2 : Issues in Caring

Unit 3 : Legislation and Governmental Agencies

Unit 4 : Non Governmental Agencies

Block-6: Rehabilitation Geriatrics

Unit 1 : Principles of Rehabilitation

Unit 2 : Medical Rehabilitation

Unit 3 : Social Rehabilitation

Course MMEL-004: Basic Geriatrics Practical

Section 1: Getting to Know Our Elderly

Chapter 1: Assessment of Geriatric Patient at Home

Chapter 2: Assessment of Geriatric Patient at Home

Chapter 3: Assessment of Geriatric Patient at Home

Section 2: Health Education and Counselling

Chapter 1: Counselling

Chapter 2: Health Education

Section 3: Diet and Nutrition

Chapter 3: Nutritional Assessment

Chapter 4: Dietary Advice

Section 4: Psychosocial and Rehabilitation Geriatrics

Chapter 1: Visits to Day Care Centre and Old Age Home

Chapter 2: Rehabilitation Geriatrics

Course MME-005: Clinical Geriatrics

Block-1 Different Face of Clinical Geriatrics

Unit 1 : How Elderly are Different?

Unit 2 : Investigating the Elderly

Unit 3 : Infection and Immunity

Block-2: Gastrointenstinal and Respiratory Disorders

Unit 1 : Disorders of Upper Gastrointestinal Tract

Unit 2 : Disorders of Lower Gastrointestinal Tract

Unit 3 : Disorders of Liver, Biliary System and Pancreas

Unit 4 : Infections of Respiratory System

Unit 5 : Non-infective Disorders of the Respiratory System

Block-3: Cardiovascular and Haematological Disorders

Unit 1 : Congestive Cardiac Failure, Hypertension and Hypotension

Unit 2 : Ischemic Heart Disease

Unit 3 : Valvular Heart Diseases and Infective Endocarditis

Unit 4 : Anaemia and Haemato-oncology

Block-4: CNS and Neuro-psychiatric Disorders

Unit 1 : Cerebro Vascular Diseases

Unit 2 : Depressive and Psychiatric Disorders

Unit 3 : Congnitive Impairment and Dementia

Unit 4 : Neuro-degenerative Disorders

Unit 5 : Infections of Central Nervous system, Sleep Disorders and Coma

Block-5: Genitourinary and Endocrinological Disorders

Unit 1 : Fluid and Electrolyte Imbalance

Unit 2 : Urological Disorders

Unit 3 : Gynaecological Problems

Unit 4 : Diabetes Mellitus

Unit 5 : Thyroid, Obesity and Sexuality

Block-6: Musculoskeletal and Special Senses Disorders

Unit 1 : Osteoporosis

Unit 2 : Disease of the Joints

Unit 3 : Fractures and Musculotendinous Disorder

Unit 4 : Visual Impairment

Unit 5 : Ear, Nose and Throat Disorders

Unit 6 : Diseases of the Oral Cavity

Block-7: Malignancies and Terminally Ill

Unit 1 : Basic Principles of Oncology

Unit 2 : Common Malignancies

Unit 3 : Common Malignancies in Women

Unit 4 : Palliative Care

Block-8: Miscellaneous Disorders

Unit 1 : Principles of Geriatric Surgery

Unit 2 : Common Emergencies

Unit 3 : Poisoning and Accidents

Unit 4 : Dermatological Disorders

Unit 5 : Disorders of Balance

Unit 6 : Hernias

Course MMEL-005: Clinical Geriatrics Practical

Section 1: Assessment of Geriatric Patient

Chapter 1: History Taking and General Physical Examination

Chapter 2: Common Bedside Procedures

Chapter 3: Critical Analysis of Drug Prescription Writing

Section 2: Clinical Evaluation-I

Chapter 1: Gestatrointestinal History and Abdominal Examination

Chapter 2: Assessment of Respiratory System

Section 3: Clinical Evaluation-II

Chapter 1: Assessment of Cardiovascular System

Chapter 2: Assessment of Endocrionological System

Section 4: Clinical Evaluation-III

Chapter 1: Assessment of Genitourinary System

Chapter 2: Assessment of Endocrinological System

Section 5: Clinical Evaluation-IV

Chapter 1: Assessment of Musculoskeletal System

Chapter 2: Assessment of Dermatological System

Chapter 3: Assessment of Special Senses

Section 6: Miscellaneous Practicals

Chapter 1: Investigations and Interpretations in a Geriatric Patient

Chapter 2: Orientation and Elective Visits

Block 2: Log-book

List of Practical Skills

The skills that you are expected to learn in each course are mentioned below. In each of the skills, you will be demonstrated at least one case with explanation of key steps that are mentioned in each of them. After demonstration, each of you will be given scope to perform the procedure in at least one patient under the supervision of the counsellor at PSC. For this purpose, you will be posted to OPD, Ward, OT, Emergency etc. as applicable for different skills. The activities and field visits which you are expected to complete in different courses are given below. You will find the details of each in the respective practical manuals.

Activities of MMEL-004: Basic Geriatrics Practical

• Community Medicine Component

• Assessment of Nutrition

• Diet Planning

• Planning and Conduction of Group Discussion

• Providing Health Education Talks

• Planning and Conduction of Counselling

• Family Study

• Home Assessment of Geriatric Patient

• Follow Up of Five Families at Work Place

• Field Visits

Visits to the following institutions for observing the geriatric care

• Old Age Home

• Day Care Centre

• Orthopaedic Component

• Assessment of Musculoskeletal System

• Examination of Extremities and Spine

• Limb Length Discrepancy

• Range of Movement of Joints

• Assessment of Physical Disability

• Physiotherapy Exercises

• Upper Limb Exercises including PA, RA

• Lower Limb Exercises including OA,THR,TKR

• Spinal Exercises

• Heat and Cold Therapy

• Transferring a Patient

• Balance and Gait Training

• Use of Orthopaedic Aids

• Application of Splints

• Application of Elastocrepe Bandage

• Maintenance of Asepsis

• Investigations including X-ray

Activities of MMEL-005 : Clinical Geriatrics Practical

• History Taking and General Physical Examination of Geriatric Patient

• Systemic Examination

• Respiratory System

• Cardiovascular System

• Nervous System

• Genitourinary System

• Endocrinology System

• GI System and Abdominal Examination

• Bedside Procedures

• Abdominal Tap

• Pleural Tap

• Bladder Catheterisation

• Ryles Tube Insertion

• Enema

• Per Rectum Examination

• Electrocardiography

• X-ray

• History Taking and Examination of Skin Disorders

• History Taking and Examination of Psychiatric Disorders

• Dental Caries and Oral Health

• Deafness and Hearing

• Examination of Cataract and Glaucoma

Source: IGNOU official Website



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